Type:
Educational Exhibit
Keywords:
Abdomen, Interventional vascular, Veins / Vena cava, Catheter venography, Digital radiography, Diagnostic procedure, Sampling, Endocrine disorders, Hypertension
DOI:
10.26044/ranzcr2023/C-147
Background
Primary Aldosteronism (PA) is the predominant cause of secondary hypertension, implicated in approximately 6% of all hypertensive patients, and up to 20% with refractory hypertension. It causes several sequelae independent of secondary hypertension, and therefore leads to greater morbidity/mortality than essential hypertension (1).
Once diagnosis of PA is confirmed, it needs to be determined whether hormone production is unilateral or bilateral. The most likely cause of unilateral aldosterone production is aldosterone producing adenoma (APA). Less common aetiologies include nodular or diffuse unilateral hyperplasia. The best prognosis for excessive unilateral aldosterone production is seen with adrenalectomy, whereas bilateral disease is most effectively treated medically (1, 2, 3). There are several techniques for lateralisation of aldosterone production. however modern standards recommend adrenal vein sampling (AVS) as the gold standard (2).